Boston Medical Center
Senior Claims Analyst, Pharmacy Revenue Cycle
Boston Medical Center, Myrtle Point, Oregon, United States, 97458
Employer Industry: Healthcare Revenue Cycle Management
Why consider this job opportunity
Opportunity for career advancement and growth within the organization Full-time position with a focus on a collaborative and specialized approach in pharmacy revenue cycle Competitive salary and benefits package (specific salary details not provided) Chance to work with a team of experts in the pharmacy and medical revenue cycle fields Work in a supportive environment that prioritizes compliance and quality care for patients Engage in meaningful work that contributes to the financial health of the healthcare organization Job Responsibilities
Research, resolve, and prepare claims that have not passed payer edits and determine actions to resolve rejected drug claims Serve as a subject matter expert for strategic provider relationships and reimbursement issues Monitor rejections on electronic and paper claims to identify areas for system enhancements Collaborate with revenue cycle departments to improve denials and avoidable write-offs Analyze inquiries regarding compliance, payer policies, and inappropriate coding to ensure accurate billing Qualifications
Bachelor’s degree in Business, Healthcare, or a closely related field or equivalent work experience Minimum of 5 years of experience in healthcare, coding, finance, revenue cycle, patient accounting, or physician billing Advanced working knowledge of professional billing flows and revenue cycle tasks Strong analytical skills to solve complex problems related to system processes and workflows Knowledge of Medicare billing codes and practices, including CPT/HCPCS and ICD-10-CM-PCS diagnosis codes Preferred Qualifications
Certification as a Pharmacy Technician or Certified Coder (CPC or RIHT) Experience in a Medical Center setting, particularly in Oncology or Home/Office Infusion settings Strong interpersonal skills to effectively communicate with various stakeholders Familiarity with drug NDC numbers and unit conversion Experience as a Subject Matter Expert (SME) for complex denials and payment variances We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
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Opportunity for career advancement and growth within the organization Full-time position with a focus on a collaborative and specialized approach in pharmacy revenue cycle Competitive salary and benefits package (specific salary details not provided) Chance to work with a team of experts in the pharmacy and medical revenue cycle fields Work in a supportive environment that prioritizes compliance and quality care for patients Engage in meaningful work that contributes to the financial health of the healthcare organization Job Responsibilities
Research, resolve, and prepare claims that have not passed payer edits and determine actions to resolve rejected drug claims Serve as a subject matter expert for strategic provider relationships and reimbursement issues Monitor rejections on electronic and paper claims to identify areas for system enhancements Collaborate with revenue cycle departments to improve denials and avoidable write-offs Analyze inquiries regarding compliance, payer policies, and inappropriate coding to ensure accurate billing Qualifications
Bachelor’s degree in Business, Healthcare, or a closely related field or equivalent work experience Minimum of 5 years of experience in healthcare, coding, finance, revenue cycle, patient accounting, or physician billing Advanced working knowledge of professional billing flows and revenue cycle tasks Strong analytical skills to solve complex problems related to system processes and workflows Knowledge of Medicare billing codes and practices, including CPT/HCPCS and ICD-10-CM-PCS diagnosis codes Preferred Qualifications
Certification as a Pharmacy Technician or Certified Coder (CPC or RIHT) Experience in a Medical Center setting, particularly in Oncology or Home/Office Infusion settings Strong interpersonal skills to effectively communicate with various stakeholders Familiarity with drug NDC numbers and unit conversion Experience as a Subject Matter Expert (SME) for complex denials and payment variances We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
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